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Too few with arthritis are exercising, study finds

Numbers lower than expected even though research has shown that exercise can reduce pain

By Janice Neumann, Special to the Tribune

August 31, 2011

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Rahnee Patrick remembers the stories about her grandfather crying from painful arthritis as he milked his cows, his only relief coming from rest or cortisone shots.

Today, Patrick, 37, takes a far different approach to her own arthritis, pedaling away at her stationary bike and lifting weights in the comfort of her South Loop home. Patrick, whose psoriatic arthritis affects most of her joints, says the exercise, in addition to several anti-inflammatory medications, helps her stiff joints and makes her feel better.

Though research has shown that exercise can reduce pain, ease stiff joints, fight depression and help with a host of other health problems, a study published this month by researchers at Northwestern University's Feinberg School of Medicine found that even fewer people with arthritis than previously thought are getting enough exercise.

Researchers studied more than 1,000 people ages 49 to 84 with knee osteoarthritis (a degenerative joint disease), and the subjects wore a type of pedometer to measure their physical activity level for a week. Only 13 percent of men and 8 percent of women met federal guidelines of 2.5 hours of moderate-intensity, low-impact activity per week, according to the study, which appeared in the journal Arthritis & Rheumatism.

"That is incredibly concerning," said Dorothy Dunlop, associate professor of medicine at Northwestern and a lead author of the study. "Being overweight is certainly common in people with osteoarthritis, and if these people are inactive that complicates their ability to lose weight, as well as denies them the benefits of physical activity," she said.

Dunlop said exercise could be incorporated into daily living. For example, she said she walks from her Northwestern office downtown to Union Station daily and "gets home feeling like I've actually done something for myself."

About 46 million Americans have arthritis, which becomes more common as people age, according to the Arthritis Foundation. Osteoarthritis is the most frequent type, followed by rheumatoid arthritis, an autoimmune disease characterized by inflammation of the membrane lining the joint.

Dr. Rowland Chang, another author of the study, who is also Patrick's rheumatologist, said if joints were particularly painful, a physical therapist could recommend strengthening exercises. There are a number of exercises that can be affordably accessed through the Arthritis Foundation, senior centers and public health organizations, he said.

"Just being generally fit will likely reduce pain associated with active inflammation," said Chang, who is a professor of preventive medicine and physical medicine and rehabilitation at Northwestern. "If it's a particularly bad joint, strengthening exercises would help mechanically."

Chang said more national attention is needed to encourage people with arthritis to exercise.

Many people don't realize how exercise can help avoid arthritic problems, said Dr. Steve Gnatz, medical director of rehabilitation at Loyola University Medical Center. Gnatz said that throughout life our bodies are constantly making and breaking down cartilage. Age, obesity and trauma break down the cartilage, while exercise helps remake it, he said.

"Intuitively, you don't always think you should be exercising more because it hurts. So one of the body's responses to pain is you stop doing things. ... It's a vicious cycle," said Gnatz, who also is a professor of orthopedic surgery and rehabilitation and physical medicine and rehabilitation.

Helen Schell, of Oak Park, who has arthritis in her hip and back, said aqua therapy has been a lifesaver. Gnatz, who treats Schell for scoliosis and suggested the therapy, has found she's even walking better. The therapy puts less stress on the joints than other forms of exercise.

During aqua therapy, a therapist helps Schell stretch through walking, paddling and pulling her limbs, all while Schell is immersed in warm water.

"Before I go in, I feel achy and can hardly stand up," said Schell. "It feels just wonderful afterward," said Schell, who recently turned 80.

Patrick experiences a similar feeling of well-being from her exercise routine, which also includes walking her dog regularly.

"My desire is to live on this earth as long as possible with my arthritis," Patrick said, "and for that to happen I've got to really take care of my body."